甲巯咪唑治疗妊娠合并甲状腺功能亢进安全性分析(1)
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[摘要] 目的 分析甲巯咪唑治疗妊娠合并甲状腺功能亢进的安全性和可行性。方法 选择38例妊娠合并甲状腺功能亢进产妇，使用甲巯咪唑治疗，并与未使用药物控制的妊娠合并甲状腺功能亢进产妇进行比较，统计分析甲巯咪唑治疗产妇甲亢后，新生儿甲状腺功能变化以及发生先天性畸形情况。 结果 在新生儿断脐前抽取脐静脉血检测的甲状腺激素发现，观察组的TT3、TT4、FT3、FT4以及TSH均明显低于对照组(P < 0.05)，观察组新生儿先天性畸形发生率明显少于对照组(P < 0.05)。 结论 甲巯咪唑治疗妊娠合并甲状腺功能亢进，虽有部分新生儿畸形的发生，但总体上能减少新生儿畸形发生率，维持新生儿甲状腺功能，可在定期监测胎儿生长发育情况的前提下使用。
[关键词] 甲巯咪唑；妊娠合并甲状腺功能亢进；新生儿畸形；甲状腺功能
[中图分类号] R581.1 [文献标识码] C [文章编号] 1673-7210(2012)04(a)-0182-02
Safety analysis of Methimazole in the treatment of hyperthyroidism during pregnancy
JIANG Lihua
Department of Obstetrics, Kunshan Hospital of Traditional Chinese Medicine, Jiangsu Province, Kunshan 215300, China
[Abstract] Objective To analyze the safety and feasibility of Methimazole in the treatment of hyperthyroidism during pregnancy. Methods Thirty-eight puerperae with hyperthyroidism during pregnancy received the Methimazole treatment and were compared with the puerperae with hyperthyroidism during pregnancy who didn't receive the Methimazole treatment. The neonates' thyroid function changes and incidence of congenital malformation were analyzed statistically after the Methimazole treatment of hyperthyroidism. Results The thyroid hormone detected in the umbilical cord venous blood extracted before cutting off the umbilical cord showed that the observation group was significantly lower than the control group in the TT3, TT4, FT3, FT4 and TSH (P < 0.05) and that the observation group was significantly lower than the control group in the incidence of congenital malformation (P < 0.05). Conclusion Although the Methimazole treatment of hyperthyroidism during pregnancy leads to some neonatal malformation, but in general it can reduce the incidence of neonatal malformation and maintain neonatal thyroid function, and therefore it can be used in the context of regular monitoring of fetal growth and development.
[Key words] Methimazole; Hyperthyroidism during pregnancy; Neonatal malformation; Thyroid function
孕妇严重的甲亢可引起流产、死胎、宫内生长迟缓、早产、先天畸形等，甲亢治疗的孕妇早产发生率为4%～11%，而未治疗的孕妇早产发生率为53%[1]，妊娠合并甲亢，特别是在孕晚期，母亲循环血量增加，中重度妊高征和心力衰竭发生增加 ......
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